Drug for terminal liver cancer patients 'too expensive'

A last ditch drug hope for people with advanced liver cancer has been dashed
by the NHS drugs rationing body.

The National Institute for health and Clinical Excellence (Nice) has turned down a new drug to combat advanced liver cancer because it is too expensive to justify the modest benefits it provides.

Nexavar, also called sorafenib, extends the life of terminal patients by an average of 2.8 months but some have lived for over one year. Between 600 and 700 patients out of the 3,000 a year diagnosed with liver cancer would be eligible for treatment with Nexavar.

However the cost to the NHS of treating them would be £9 million a year, a spokesman for Nice said.

Makers of the drug, Bayer, offered to pay for every fourth packet of treatment bringing the NHS cost down to £7.7m but this was still too high given the short amount of time it increases life expectancy by, Nice said.

Alison Rogers, Chief Executive of the British Liver Trust, said: "The decision to reject a treatment for advanced liver cancer is a huge blow for patients.

"This is a treatment to extend life for people where all other options have run out. It is particularly hard for people with liver cancer given that treatments for many other advanced cancers have been given the green light by Nice.

"People with liver disease often face stigma and discrimination and sadly this decision feels like a further disadvantage to them.

"To be told extension of life is not ‘an acceptable use of NHS resources’, however rationally based the rationing system is, will cause unbearable pain and distress to patients and their families.”

Liver cancer has a poor prognosis and survival from diagnosis can be as short as eight months.

Nicole Farmer, of Bayer Schering Pharma Oncology, said: “While we recognise that Nice has difficult decisions to make, we are without doubt that today’s guidance goes completely against UK treatment guidelines, Nice’s own ’end of life’ criteria and the current government strategy to bring cancer outcomes in line with Europe.

"We shall appeal against the decision and if we are successful, this will enable the NHS to offer a similar level of access to Nexavar as other EU countries such as France, Germany, Spain, Italy and Romania where it has already been granted funding.”

Andrew Dillon, Chief Executive of Nice, said: “We were disappointed not to have been able to recommend the use of sorafenib, but after carefully considering all the evidence, including the proposed ‘patient access scheme’ in which the manufacturer offered to provide every fourth pack free, sorafenib does not provide enough benefit to patients to justify its high cost.

“We have recently changed our approach to appraising high cost treatments which can extend life for terminally ill patients. This has meant that more of them are now being recommended. We looked at sorafenib in just the same way but the price being asked by Bayer is simply too high to justify using NHS money which could be spent on better value cancer treatments.”

The recommendation not to approve Nexavar for NHS use is still under consultation and final guidance is due to be issued in January.